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This is VAERS ID 283771

Case Details

VAERS ID: 283771 (history)  
Form: Version 1.0  
Age: 21.0  
Gender: Female  
Location: Michigan  
Vaccinated:2007-04-13
Onset:2007-05-03
   Days after vaccination:20
Submitted: 2007-06-14
   Days after onset:42
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 1 UN / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Anogenital warts, Biopsy
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NUVARING
Current Illness:
Preexisting Conditions: Papilloma viral infection; loop electrosurgical excision procedure
Allergies:
Diagnostic Lab Data: biopsy, condyloma
CDC Split Type: WAES0705USA01186

Write-up: Information has been received from a physician concerning a 21 year old female with no known drug reactions or allergies and a history of papilloma viral infection and loop electrosurgical excision procedure (2005) who on 13-APR-2007 was vaccinated with Gardasil. Concomitant therapy included NUVARING. On 03-MAY-2007 the patient developed condyloma on her vulva and vagina. A biopsy of the condyloma was taken (results pending). The Gardasil was not reintroduced. Additional information has been requested.


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